Provider Demographics
NPI:1477288215
Name:HOLLEY, LANDON JAMES (DDS)
Entity Type:Individual
Prefix:DR
First Name:LANDON
Middle Name:JAMES
Last Name:HOLLEY
Suffix:
Gender:M
Credentials:DDS
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:675 ROCKY KNOLL LN
Mailing Address - Street 2:
Mailing Address - City:DANVILLE
Mailing Address - State:VA
Mailing Address - Zip Code:24541-8933
Mailing Address - Country:US
Mailing Address - Phone:434-250-9137
Mailing Address - Fax:
Practice Address - Street 1:2657 FRANKLIN TPKE
Practice Address - Street 2:
Practice Address - City:DANVILLE
Practice Address - State:VA
Practice Address - Zip Code:24540-1053
Practice Address - Country:US
Practice Address - Phone:434-793-4353
Practice Address - Fax:
Is Sole Proprietor?:No
Enumeration Date:2022-07-17
Last Update Date:2022-07-17
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
VA0401417980122300000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes122300000XDental ProvidersDentist